Simple JSON rendering (via API)

General information for the business: Not for a business, general API review/hacking
Description of every module: This is a simple webpage that will have an input form. Form data will be a URL. No field validation is required.
Description of requirements/functionality: Posted URL's will then be fired to a specific (just one) external API. The API will return JSON.

If success (the fields required are returned) the data should be displayed in an HTML template (will be supplied) along with the form to submit a new URL.

If fail (the fields required are not returned), a simple error should be shown "The url: $url did not return any data"

This does not need to be fancy. This is to help test an API I wish to use, so no other requirements (security, responsiveness, etc) are required.
Specific technologies required: HTML5, Javascript, JSON, APIs
Extra notes: I need this in a rush, so please only bid if you are available now.